Organization
RENEW COMPOUNDING PHARMACY
Active
Other names
Renew Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ANDERSON (OWNER)
(615) 891-7776
Entity
Organization
Contact information
Practice address
7105 CROSSROADS BLVD STE 105, BRENTWOOD, TN 37027-2806
(615) 891-7776
(615) 891-7393
Mailing address
7105 CROSSROADS BLVD, SUITE 105, BRENTWOOD, TN 37027-2806
(615) 891-7776
(615) 891-7393
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5083
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4445385
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2012
Last updated
10/19/2012
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